title: Posterior lamellar graft preparation: a prospective review from an eye bank on current and future aspects.
abstract: Descemet membrane endothelial keratoplasty (DMEK) is a corneal surgical technique which selectively replaces the damaged posterior part of the cornea with a healthy donor graft retaining the rest of the tissue intact. There is a need to validate and standardize the donor tissue before grafting due to certain issues that can lead to consequences such as graft failure due to poor endothelial cell count, higher mortality, detachment of the graft, or increased surgical expenses, time, and effort. Thus, prospective potential surgeons and eye banks should now aim at developing new improved surgical techniques in order to prepare the best suited, validated, precut, preloaded, and easy to transplant tissue to reduce pre- and postsurgical complications. This could be achieved by defining parameters like graft thickness, accepted mortality threshold of the endothelial cells, and behavior of grafts during preservation and transportation along with using more sophisticated instruments like microkeratome and femtosecond lasers for graft preparation. Thus, a rapport between the eye banks and the surgeons along with the advanced instruments can overcome this challenge to find the best possible solution for endothelial keratoplasty (EK).
authors.affiliation: The Veneto Eye Bank Foundation, Padiglione Rama, Via Paccagnella 11, Zelarino, 30174 Venice, Italy.
authors.forename: Mohit
authors.initials: M
authors.lastname: Parekh
authors.forename: Gianni
authors.initials: G
authors.lastname: Salvalaio
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ruzza
authors.forename: Davide
authors.initials: D
authors.lastname: Camposampiero
authors.forename: Carlo
authors.initials: C
authors.lastname: Griffoni
authors.forename: Alfonso
authors.initials: A
authors.lastname: Zampini
authors.forename: Diego
authors.initials: D
authors.lastname: Ponzin
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferrari